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Frequently Asked Questions

How old is the fellowship?

The fellowship began in 1994 as a training program for doctors with a background in emergency medicine. Dr. Michael F. Altieri, a pediatrician and one of the earliest fellowship trained pediatric emergency medicine physicians, devoted his career to teach the art of pediatric emergency care to doctors who would eventually staff general community emergency facilities. The program added a pediatrics track in 1997.


Will I be trained by pediatric emergency medicine faculty in the ED, or is it staffed by pediatricians?

The majority of faculty is double-boarded in EM/PEM. Two members completed training in PED/PEM and the remainder completed two residencies in PED and EM. The fellows in the PED track spend time with board-certified emergency medicine faculty while on rotation in the adult unit. The faculty has appointments at George Washington University, University of Virginia and Virginia Commonwealth University.


Is the program accredited by the ACGME?

Yes, the program is fully accredited through the Pediatrics RRC.


If I am an EM graduate, will I have to train for three years?

No! There is a separate curriculum for graduates of EM residencies. Application for the board exam for EM graduates is through the American Board of Emergency Medicine.


Will I have to take call? What are the duty hours like?

Some rotations require call, such as ward pediatrics (EM only) and PICU, as well as trauma surgery (ped track only). Duty hours approach 80/30 on these rotations, however, Duty Hour policies are adhered to strictly to prevent violation of the duty hours. Our close relationship with the pediatric chief residents ensures that scheduling is never an issue.


What is the attitude of the faculty to fellow staffing and supervision?

The faculty and nursing staff could not imagine the ED without fellows. It is fully staffed with 24-hour PEM coverage and double coverage during the evening hours by general emergency attendings. Fellows work in addition to these attendings, at peak pediatric hours, so there is ample supervision.


How many shifts do I work a week as a fellow in the ED?

Average hours worked per week approaches 40 hours as a junior fellow. The shifts are ten hours long, usually from 1 p.m. to 11 p.m. and on weekends from 10 a.m. to 8 p.m. or 4 p.m. to 2 a.m. The fellows do not work overnight.


How many conferences are there?

Conference is held every Thursday, in addition to Emergency Medicine Grand Rounds with the GW residency once a month. Attendance is compulsory and protected time is given the night before and the morning of conference to allow attendance. Core pediatric lectures on Tuesdays are required while fellows are on inpatient or pediatric subspecialty lectures. Other general topics, such as medical legal issues, customer service, sleep deprivation and cultural competency, are provided at mandatory monthly Educational Grand Rounds.


Does the faculty attend conference? Who else is there?

Yes. The program director is present and the core faculty takes turns, as some of us have to work! Also present are residents and medical students. This is a specially designed learning experience, allowing ample opportunity to teach and be taught.


What are the salary and benefits?

Salaries are based on mid-Atlantic averages. Benefits include health insurance, malpractice, etc., through Inova. 


Is moonlighting allowed?

Moonlighting for pediatric-trained fellows is not permitted in the first year due to our rigorous schedule, unless special circumstances exist for moonlighting and only with permission from the program director. The program director will not endorse PED-trained fellows to moonlight as a PEM attending elsewhere during the first year of training. EM trainees who are already board certified in emergency medicine may moonlight with the expressed written permission of the program director. Moonlighting schedules need to be approved ahead of time. No more than 30 hours can be approved per block. Moonlighting hours ARE considered duty hours and need to be included in duty hour documentation. Fellows should be aware that Inova WILL NOT cover malpractice for moonlighting positions in or out of the institution.


Is there protected time for research?

The Research Curriculum begins in the first year, with protected time during clinical months. Research is a focus of our recently updated program and statistical methods are discussed on a continual basis during conference. Mentorship is available through the program and the core pediatric residency.


What makes this program a great place to train?

Our community-based program, in the words of our section chief Rick Place, is a “mom and pop shop where we care about our fellows." Frequent interaction with faculty enables maximization of learning opportunities. You get to know us, and we get to know you. You will be watched closely.

An emphasis of the program is to train PEM specialists that are knowledgeable, resourceful, and who feel comfortable to practice anywhere.  Program curricula are carefully designed and tailored to fit individual needs. The curricula are constantly under renovation. Fellow input is key to this developmental process. Re-invention of journal club, scholarly activity with its Statistical Concepts Conference and article review are excellent forums for state-of-the-art patient care discussions. Longitudinal administrative assignments allow a unique behind-the-scenes experience in Emergency Department administration. Fellows are involved in educational programs within the fellowship and pediatric residency; fellows’ presentation skills are also scrutinized during time in the program. Dr. Kou, Program Director, is particularly concerned that fellows should know how they are being evaluated and encourages fellows to gain knowledge of the ACGME, academic institutional requirements and lifelong learning. For the EM track, she is very proud of the pediatric mini-residency. Fellows uniformly feel well trained after completing the program.

Inova Fairfax Hospital has long been a site of graduate medical education and with its proximity to the DC metro area, provides a truly unique backdrop for all kinds of disease presentation. There is a busy congenital cardiac program, subspecialty cases galore, and all spectrum of disease states as well as a diverse patient population.

Finally, there is no such thing as a stupid question. (We worry more if you don’t have any questions.)